Michael S Sparks, DDS.,MS
Individual provider Active NPI Dentist · Albuquerque, NM
NPI 1831241645 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831241645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DD2729 (NM)
- Practice address
- 10425 Montgomery Pkwy NE
Albuquerque, NM 87111-3864 - Phone
- (505) 291-9000
- Fax
- (505) 294-3998
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD2729 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albuquerque Implant & Periodontal Consultants. LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD2729 | NM | Yes |
Addresses
Primary practice location
10425 Montgomery Pkwy NE
Albuquerque, NM 87111-3864
Mailing address
10425 Montgomery Pkwy NE
Albuquerque, NM 87111-3864
Phone (505) 291-9000
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.